Introduction

Ear infections are among the most common reasons for medical consultations in both children and adults. They can affect different parts of the ear and vary from mild, self-limiting conditions to more serious infections requiring prompt medical treatment.

The two most common types are otitis externa, often called swimmer's ear, and otitis media, an infection of the middle ear. Although both conditions can cause ear pain, they have different causes, symptoms and treatments.

During the warmer months, ear infections become particularly common in Mallorca due to frequent swimming, water sports and prolonged exposure to moisture. Children are especially prone to middle ear infections, while adults commonly develop swimmer's ear after repeated contact with water.

Recognising the symptoms early and seeking appropriate medical assessment can help relieve discomfort, prevent complications and preserve hearing.

What Is an Ear Infection?

An ear infection occurs when bacteria, viruses or, less commonly, fungi cause inflammation in part of the ear.

The ear is divided into three sections:

• The outer ear.
• The middle ear.
• The inner ear.

Infections most commonly affect the outer or middle ear.

Because each part has a different function, the symptoms and treatment vary depending on which area is involved.

Types of Ear Infections

Otitis Externa (Swimmer's Ear)

Otitis externa is an infection of the outer ear canal.

It commonly develops when water remains trapped inside the ear after swimming, creating a moist environment that allows bacteria or fungi to grow.

Typical symptoms include:

• Ear pain.
• Pain when touching or pulling the ear.
• Itching.
• Redness.
• Swelling of the ear canal.
• Ear discharge.
• Temporary reduction in hearing.

Swimmer's ear is particularly common during the summer months.

Otitis Media (Middle Ear Infection)

Otitis media affects the space behind the eardrum.

It often develops following a cold or upper respiratory tract infection, when swelling blocks the Eustachian tube and fluid becomes trapped behind the eardrum.

Symptoms commonly include:

• Ear pain.
• Fever.
• Reduced hearing.
• Feeling of pressure inside the ear.
• Irritability in young children.
• Difficulty sleeping.

Some patients may develop a perforated eardrum with drainage of fluid from the ear, which often relieves pressure and pain.

Inner Ear Disorders

The inner ear is responsible for hearing and balance.

Conditions affecting this area, such as labyrinthitis or vestibular neuritis, are usually not considered typical ear infections, although they may follow viral illnesses.

Symptoms may include:

• Severe dizziness (vertigo).
• Nausea.
• Vomiting.
• Balance problems.
• Hearing changes in some cases.

These conditions require medical assessment because several other disorders can produce similar symptoms.

What Causes Ear Infections?

Different types of ear infections have different causes.

Common causes include:

• Bacterial infections.
• Viral infections.
• Fungal infections (particularly otitis externa).
• Water trapped in the ear canal.
• Skin irritation.
• Eczema affecting the ear.
• Allergies causing Eustachian tube dysfunction.
• Upper respiratory tract infections.
• Enlarged adenoids in children.

Sometimes several contributing factors occur together.

Risk Factors

Several factors increase the likelihood of developing an ear infection.

These include:

• Frequent swimming.
• Water sports.
• High humidity.
• Narrow ear canals.
• Cleaning the ears with cotton buds or other objects.
• Eczema or psoriasis.
• Seasonal allergies.
• Recent colds.
• Young age.
• Exposure to tobacco smoke.
• Weakened immune system.

Swimming and prolonged exposure to moisture make otitis externa especially common among residents and visitors to Mallorca during the summer.

Common Symptoms of an Ear Infection

Symptoms depend on which part of the ear is affected.

Common symptoms include:

• Ear pain.
• Feeling of pressure or fullness.
• Temporary hearing loss.
• Ear itching.
• Ear discharge.
• Redness.
• Swelling.
• Fever.
• Dizziness in some cases.
• Ringing in the ear (tinnitus) occasionally.

In children, symptoms may also include:

• Pulling at the ear.
• Crying more than usual.
• Difficulty sleeping.
• Poor feeding.
• Irritability.

The combination of symptoms often helps determine which type of ear infection is present.

When Should You Seek Medical Care?

Although many ear infections improve with appropriate treatment, some require prompt medical assessment to prevent complications.

You should seek medical attention if you experience:

• Severe ear pain.
• Ear pain lasting more than 48 hours.
• Fever above 38.5°C.
• Pus or blood draining from the ear.
• Sudden hearing loss.
• Persistent dizziness or vertigo.
• Swelling or redness spreading around the ear.
• Symptoms that worsen despite treatment.
• Ear pain following an injury.
• Symptoms occurring in infants younger than six months.

Urgent medical assessment is particularly important if hearing changes, severe pain or neurological symptoms develop.

How Is an Ear Infection Diagnosed?

Diagnosis begins with a detailed medical history and physical examination.

Your doctor will ask about:

• When the symptoms began.
• The severity of the pain.
• Recent swimming or water exposure.
• Recent colds or respiratory infections.
• Hearing changes.
• Ear discharge.
• Fever.
• Previous ear infections.
• Allergies or skin conditions.

During the examination, the doctor will assess:

• The outer ear.
• The ear canal.
• The eardrum (tympanic membrane).
• Signs of inflammation.
• Ear discharge.
• Swelling.
• Hearing when appropriate.

The examination is usually performed using an otoscope, a handheld instrument that allows the healthcare professional to visualise the ear canal and eardrum.

Additional Investigations

Most uncomplicated ear infections do not require additional tests.

However, further investigations may occasionally be recommended if:

• Symptoms are severe.
• Hearing loss is significant.
• Infections are recurrent.
• Treatment has not been effective.
• Complications are suspected.

Depending on the situation, these investigations may include:

• Hearing assessment (audiometry).
• Ear swabs if persistent discharge is present.
• Blood tests in selected cases.
• Referral to an Ear, Nose and Throat (ENT) specialist.
• Imaging studies in rare or complicated cases.

Treatment for Ear Infections

Treatment depends on which part of the ear is affected and the underlying cause.

Treatment for Otitis Externa

Management commonly includes:

• Keeping the ear dry.
• Cleaning the ear canal when appropriate.
• Prescription ear drops containing antibiotics, corticosteroids or antifungal medication, depending on the cause.
• Pain relief if required.

Swimming should generally be avoided until the infection has completely resolved.

Treatment for Otitis Media

Many middle ear infections improve without antibiotics, particularly when caused by viruses.

Depending on the patient's age, symptoms and clinical findings, treatment may include:

• Observation and symptom monitoring.
• Pain relief.
• Antibiotics when a bacterial infection is considered likely or symptoms are more severe.

Treatment decisions should always be individualised and follow current clinical guidelines.

Pain Management

Ear pain can usually be managed with appropriate pain relief recommended by your healthcare professional.

Applying warmth to the outside of the ear may provide additional comfort for some individuals, provided there is no concern about burns or skin injury.

Treatment of Complications

Occasionally, complications require specialist assessment.

These may include:

• Persistent fluid behind the eardrum.
• Recurrent middle ear infections.
• Chronic ear discharge.
• Significant hearing loss.
• Spread of infection beyond the ear.

Referral to an ENT specialist may be appropriate in these situations.

Preventing Ear Infections

Although not every ear infection can be prevented, several measures may reduce the risk.

These include:

• Drying the ears thoroughly after swimming.
• Avoiding inserting cotton buds or other objects into the ear canal.
• Wearing ear protection when appropriate during water sports.
• Managing allergies effectively.
• Treating upper respiratory infections promptly.
• Avoiding exposure to tobacco smoke.
• Maintaining good hand hygiene to reduce viral infections.

For people who swim frequently, preventive measures may help reduce the risk of recurrent swimmer's ear.

Common Myths About Ear Infections

Myth 1: Every ear infection requires antibiotics.

False.

Many ear infections, particularly viral middle ear infections, improve without antibiotics.

Treatment depends on the underlying cause and the severity of symptoms.

Myth 2: Cotton buds clean the ears safely.

False.

Cotton buds often push earwax deeper into the ear canal and may damage the delicate skin or even the eardrum.

The ear is usually able to clean itself naturally.

Myth 3: Swimming should continue while using ear drops.

False.

For otitis externa, avoiding swimming until the infection has resolved helps promote healing and reduces the risk of recurrence.

Myth 4: Ear infections only affect children.

False.

Although middle ear infections are more common in children, adults frequently develop ear infections, particularly swimmer's ear during the summer.

Myth 5: Hearing loss from an ear infection is always permanent.

False.

Most hearing changes associated with ear infections are temporary and improve as the infection and inflammation resolve.

Persistent hearing loss should always be medically evaluated.

Medical Assessment for Ear Infections at Dr. Indhira Ghyssaert's Practice in Mallorca

At Dr. Indhira Ghyssaert's practice in Mallorca, patients with ear pain, hearing changes or suspected ear infections receive a comprehensive medical assessment to determine the exact cause of their symptoms and recommend the most appropriate treatment.

Because ear pain may result from infections, earwax impaction, temporomandibular joint (TMJ) disorders, dental problems, throat infections or other conditions, establishing an accurate diagnosis is essential before treatment begins.

Depending on the patient's symptoms and clinical findings, the assessment may include:

• A detailed medical history.
• Physical examination.
• Otoscopic examination of the ear canal and eardrum.
• Assessment of hearing changes.
• Evaluation of associated symptoms such as fever, dizziness or ear discharge.
• Examination of the nose and throat when clinically indicated.
• Assessment for signs of swimmer's ear or middle ear infection.
• Referral for hearing tests or specialist ENT evaluation when appropriate.

Treatment recommendations are individualised and based on current evidence-based medical guidelines.

Depending on the diagnosis, management may include prescription ear drops, pain management, antibiotics when clinically indicated, advice on ear care, or referral to an Ear, Nose and Throat (ENT) specialist if complications or persistent symptoms are present.

The primary goals are to relieve pain, eliminate infection, preserve hearing and prevent recurrence.

Ear Infections While Visiting Mallorca

Ear infections are particularly common among visitors to Mallorca, especially during the summer months when swimming, diving and other water activities are popular.

Water trapped inside the ear canal can increase the risk of otitis externa (swimmer's ear), while viral upper respiratory infections acquired during travel may contribute to middle ear infections.

Travellers should seek medical assessment if they experience:

• Severe ear pain.
• Persistent hearing loss.
• Ear discharge.
• Fever.
• Swelling around the ear.
• Dizziness or vertigo.
• Symptoms that do not improve within a few days.
• Pain after swimming that progressively worsens.

Early diagnosis allows appropriate treatment and helps prevent complications that could interfere with travel plans or hearing.

Frequently Asked Questions

How can I tell if I have swimmer's ear or a middle ear infection?

Although both conditions cause ear pain, swimmer's ear usually causes pain when the outer ear is touched or pulled and often develops after swimming.

Middle ear infections are more commonly associated with recent colds, fever, pressure behind the eardrum and pain that is deeper inside the ear.

A medical examination is usually needed to distinguish between the two.

Can I fly with an ear infection?

Many people can fly safely with a mild ear infection, but changes in cabin pressure may worsen ear pain, particularly with middle ear infections.

If you have severe pain, fever or a perforated eardrum, medical advice should be sought before travelling whenever possible.

Is it safe to swim with an ear infection?

In most cases, swimming should be avoided until the infection has completely resolved, particularly in patients with otitis externa, as further exposure to water may delay healing.

Can ear infections affect hearing?

Yes.

Temporary hearing loss is common because inflammation or fluid interferes with sound transmission.

In most cases, hearing returns to normal after successful treatment.

Persistent hearing loss should always be medically evaluated.

Can ear infections resolve without treatment?

Some mild viral middle ear infections improve without antibiotics.

However, bacterial infections, swimmer's ear and persistent symptoms often require medical assessment and appropriate treatment.

Key Takeaways

• Ear infections commonly affect either the outer ear (otitis externa) or the middle ear (otitis media).
• Ear pain, hearing changes and ear discharge are common symptoms.
• Swimmer's ear is particularly common after prolonged exposure to water.
• Most ear infections respond well to appropriate treatment.
• Severe pain, persistent fever, dizziness or hearing loss require prompt medical assessment.
• Avoid inserting objects into the ear canal and keep the ears dry after swimming to help reduce the risk of infection.

Conclusion

Ear infections are common and, in most cases, respond well to early diagnosis and appropriate treatment.

Whether caused by swimming, a viral illness or a bacterial infection, recognising symptoms promptly and seeking medical advice when necessary can help prevent complications and protect hearing.

At Dr. Indhira Ghyssaert's practice in Mallorca, patients receive personalised, evidence-based medical care focused on identifying the underlying cause of ear symptoms and providing an individualised treatment plan based on current clinical guidelines.

Whether you are a resident or visiting Mallorca on holiday, early medical assessment can help relieve discomfort, support a faster recovery and minimise the risk of long-term complications.

About Dr. Indhira Ghyssaert

Dr. Indhira Ghyssaert is a physician based in Mallorca with a special interest in acute medical care, preventive healthcare and personalised medicine.

She provides comprehensive medical assessments for residents and international visitors experiencing ear infections, upper respiratory tract infections, fever and other acute medical conditions, combining evidence-based medicine with an individualised approach to patient care.

Medical Disclaimer

The information provided in this article is intended for educational purposes only and should not replace professional medical advice, diagnosis or treatment.

Ear infections can occasionally lead to complications affecting hearing or surrounding tissues. If you experience severe ear pain, sudden hearing loss, persistent dizziness, swelling around the ear, high fever or rapidly worsening symptoms, seek prompt assessment by a qualified healthcare professional.